title: Purulent skin and soft tissue infection: antibiotic selection in the community.
abstract: BACKGROUND
  Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) requently causes skin and soft tissue infections (SSTIs). Referring primary care physicians often prescribe inactive antibiotics when referring SSTIs caused by MRSA for incision and debridement.
  
  
  METHODS
  Demographics and culture results (organism and sensitivity) were collected for patients treated for SSTI between 2007-2009. Antibiotic regimens started by referring PCPs were noted. Prevalence of MRSA and antibiotic resistance profiles were tabulated. Isolates resistant to the drug initially prescribed were also noted.
  
  
  RESULTS
  Of 187 patients, 40.1% grew MRSA. All MRSA was sensitive to doxycycline and trimethoprim-sulfamethoxazole, whereas 88% were sensitive to clindamycin and 79% to levofloxacin. 48% of patients received an antibiotic inadequate for their isolate before referral.
  
  
  CONCLUSIONS
  CA-MRSA is extremely common. Patients are often prescribed antibiotics inadequate for MRSA. Doxycycline or trimethoprim-sulfamethoxazole with incision/drainage should be used as initial therapy for SSTI when MRSA is suspected.
authors.affiliation: University of Rochester Medical Center, Rochester, NY.
authors.forename: Steven Alexander
authors.initials: SA
authors.lastname: Kahn
authors.forename: Erika
authors.initials: E
authors.lastname: Venniro
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Beers
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Lentz
keywords: abscess; antibiotics; disease management; infection; primary care